血必净注射液协同亚胺培南对脓毒血症患者预后的影响  

Effect of Xuebijing Injection Combined with Imipenem on Prognosis of Patients with Sepsis

作　　者：殷章圣 侯克莉 邹云龙 YIN Zhangsheng;HOU Keli;ZOU Yunlong(ICU of Ganzhou Ganxian District People's Hospital,Ganzhou 341100,Jiangxi,China)

机构地区：[1]赣州市赣县区人民医院综合ICU,江西赣州341100

出　　处：《医学信息》2024年第21期115-118,129,共5页Journal of Medical Information

基　　金：赣州市指导性科技计划项目(编号:GZ2023ZSF367)。

摘　　要：目的研究血必净注射液协同亚胺培南对脓毒血症患者预后的影响。方法选取2020年1月-2023年9月赣州市赣县区人民医院综合ICU收治的240例脓毒血症患者,经随机数字表法分为A组(80例)、B组(80例)、C组(80例),A组给予亚胺培南治疗,B组给予血必净注射治疗,C组采用血必净注射液协同亚胺培南治疗,比较三组病死率(治疗后28d)、病情严重程度[急性生理与慢性健康评分(APACHEⅡ)]、ICU住院时间、凝血功能指标[纤维蛋白原(FIB)、血小板计数(PLT)、D-二聚体(D-D)、凝血酶时间(TT)]、炎症指标[降钙素原(PCT)、高敏C反应蛋白(hs-CRP)、淀粉样蛋白A(SAA)]、免疫功能指标[CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)]。结果C组病死率、ICU住院时间少于A组、B组(P<0.05),且C组治疗后APACHEⅡ评分低于A组、B组(P<0.05)。C组治疗后FIB、PLT、D-D水平低于A组、B组,TT水平高于A组、B组(P<0.05)。C组治疗后PCT、hs-CRP、SAA水平低于A组、B组(P<0.05)。C组治疗后CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)、IgA、IgG、IgM水平高于A组、B组,CD8^(+)低于A组、B组(P<0.05)。结论血必净注射液协同亚胺培南可降低脓毒血症病死风险,减轻疾病严重程度,缩短患者的ICU住院时间,下调其炎症因子水平,改善机体凝血状态与免疫功能。Objective To study the effect of Xuebijing injection combined with imipenem on the prognosis of patients with sepsis.Methods A total of 240 patients with sepsis admitted to the general ICU of Ganzhou Ganxian District People's Hospital from January 2020 to September 2023 were selected and divided into group A(80 patients),group B(80 patients)and group C(80 patients)by random number table method.Group A was treated with imipenem,group B was treated with Xuebijing injection,and group C was treated with Xuebijing injection combined with imipenem.The mortality rate(28 days after treatment),severity of disease[Acute Physiology and Chronic Health Evaluation score(APACHEⅡ)],ICU hospitalization time,coagulation function indexes[fibrinogen(FIB),platelet count(PLT),D-dimer(D-D),thrombin time(TT)],inflammation indexes[procalcitonin(PCT),high-sensitivity C-reactive protein(hs-CRP),amyloid A(SAA)],immune function indexes[CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+),immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM)]were compared among the three groups.Results The mortality and ICU hospitalization time of group C were less than those of group A and group B(P<0.05),and the APACHEⅡscore of group C was lower than that of group A and group B(P<0.05).After treatment,the levels of FIB,PLT and D-D in group C were lower than those in group A and group B,and the level of TT was higher than that in group A and group B(P<0.05).After treatment,the levels of PCT,hs-CRP and SAA in group C were lower than those in group A and group B(P<0.05).After treatment,the levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),IgA,IgG and IgM in group C were higher than those in group A and group B,and CD8^(+)was lower than those in group A and group B(P<0.05).Conclusion Xuebijing injection combined with imipenem can reduce the risk of sepsis death,reduce the severity of the disease,shorten the ICU hospitalization time of patients,down-regulate the level of inflammatory factors,and improve the coagulation status and immune function of the body.

关 键 词：脓毒血症 血必净注射液 亚胺培南 炎症反应 凝血功能 免疫功能 

分 类 号：R515.3[医药卫生—内科学]